Going gluten-free: the straight dope from a nutritionist

Gluten-free hype is all over the news. Olympic athletes are quitting gluten to improve their performance. Every day another celebrity is publishing a new book about how quitting gluten changed their life. It’s like there’s a conspiracy against wheat. A lot of people ask me, “What going on?”

Here are the top five questions I hear.

1. How could a food go from being a staple to something everyone should avoid? What happened?

The best explanation I’ve found is that the wheat that we enjoy now is not the wheat people ate for thousands of years. Please note that although gluten is also in barley, rye, spelt, kamut, these grains make up a small fraction of most people’s diet. The gluten-containing grain we eat every day, several times a day, is wheat.

The amount of gluten in the wheat has increased tremendously in the last 100 years. Early forms of wheat contained very little gluten. Modern wheat has been hybridized to contain much more, and flours used to make pasta and bread contain additional gluten, bringing the total percentage of gluten in flour as high as 14%. Many humans have never handled gluten very well. There are histories of digestive issues dating back to Egyptian times. The first recorded diagnosis of celiac goes back to the Roman physician, Aretaeus of Cappadocia from the second century. Gluten sensitivity is now believed to be a genetic disorder. This gene may not be triggered until overexposure or other stressors cause it to manifest, which is why many people don’t develop symptoms until adulthood.

2. What are the symptoms of gluten intolerance?

Symptoms vary dramatically from person to person. Clients of mine who have quit gluten have found relief from constipation, diarrhea, migraine headaches, sinus infections, rashes, joint pain, water retention, depression and mood swings. Gluten does a number on the nervous system by stimulating opiate receptors in the body, much like a mild form of morphine. Gluten has been known to cause seizures and schizophrenic episodes in sensitive individuals. People with autoimmune illness, such as Hashimoto’s thyroiditis and asthma are particularly likely to be sensitive to gluten, since the inflammatory protein, gliadin, found in gluten can mimic cells in the human body, triggering an autoimmune response. At this point, I routinely encourage most of my private clients to quit gluten cold turkey for a couple of weeks because the symptoms are so random, and sensitivity is so common.

3. What is the difference between celiac disease and gluten sensitivity?

Ultimately, it’s a matter of the level of inflammation in the body. If signs of intestinal inflammation show up on your lab test, then you are diagnosed with celiac disease. If your reaction is more moderate, then it is classified as gluten-sensitivity or gluten-intolerance. Just because you aren’t formally diagnosed with celiac doesn’t mean you won’t feel awful if you eat gluten, or your body hasn’t suffered any damage from eating it in the past.

For many years biopsy was held as the golden standard for diagnosis. This process is unpredictable since the acquired tissue sample might not include the damaged area. Biopsy is also a very expensive procedure and causes further trauma to the intestinal tract. Blood tests are beginning to replace biopsies, but sadly they are not totally predictable either. The immune reaction to gliadin, the real culprit, occurs inside the digestive tract, not the blood stream. Blood tests can only detect an immune reaction when intestinal inflammation so severe the digestive lining becomes permeable, so the contents of the intestines leak into the blood stream.

The most reliable lab test for gluten sensitivity is stool analysis. This test measures the immune reaction in the intestinal tract. This test is also able to detect if you have a genetic pre-disposition to gluten-sensitivity.

I don’t feel that that further testing is required if a person is convinced that they are gluten sensitive. If the client wants proof and can afford the test, then they should do it. I don’t think further testing should be required to convince the practitioner that there is a problem.

It’s possible that, in spite of your best efforts, gluten is still hiding in your diet, especially if you frequently eat out or enjoy prepared foods. Ingredients such as hydrolyzed vegetable protein, modified food starch, pre-grated cheese, and even vanilla extract may contain gluten. Food manufacturers are making more of an effort to produce gluten-free foods, especially since these changes may increase sales. Still, it’s important to look for foods that are clearly labeled as gluten-free. Cooking from scratch will further ensure your food is completely safe.

It’s possible gluten isn’t the only problem. Most people with celiac or gluten sensitivity suffer from other digestive problems due to the damage gluten has caused. If the digestive tract is so inflamed that food can leak into the blood stream, it is likely you have other food sensitivities. You may have yeast or bacterial overgrowth, or parasites. Many gluten-free breads and baked goods contain xanthan gum, which can cause bloating and digestive problems if you suffer from candida. It’s also very likely you have nutrient deficiencies due to the damage gluten has caused to your body.

Ms. Behaved’s nutrition guru Ilah Jarvis is a certified Nutrition Consultant who specializes in digestive issues. She offers private in-person or phone consultations, and cooking classes in Northern California. Check out her blog at www.eatbetterfeelbetter.com or visit her on Facebook.